Practice Management Alert

Look out for legislation and regulations that acknowledge dangers for healthcare personnel.

Workplace violence has been on the minds of more and more workers in the United States, and healthcare workers are not exempt. In fact, healthcare personnel may be more at risk of situations devolving into violence than workers in many other workplaces.

The Occupational Safety and Health Administration (OSHA) has recognized the increasing threat of workplace violence in healthcare settings, and some states are suggesting and enacting legislation to protect workers and stiffen penalties for people who commit violent acts in healthcare facilities or against healthcare personnel. Federal protections are theoretically in the works — the Safety from Violence for Healthcare Employees (SAVE) Act was introduced in the Senate in June 2022 — but right now healthcare workers do not have any standardized protections across the country.

Read on to find out more about violence in healthcare workplaces, and the legislation and regulations that might curb the crisis.

Note Some Numbers

“Workplace violence has severe consequences for the entire health care system. Not only does violence cause physical and psychological injury for health care workers, workplace violence and intimidation make it more difficult for nurses, doctors and other clinical staff to provide quality patient care. Nurses and physicians cannot provide attentive care when they are afraid for their personal safety, distracted by disruptive patients and family members, or traumatized from prior violent interactions,” says the American Hospital Association (AHA) in a fact sheet on workplace violence and intimidation.

You or a healthcare worker you know may have been affected by violence in the workplace—nonfatal intentional injuries occurred 16,450 times in 2019 alone, according to a Bureau of Labor Statistics (BLS) Survey of Occupational Injuries and Illness (SOII). Some sectors of the healthcare industry had particularly high rates of injury, including psychiatric and substance abuse hospitals. The BLS collects information on how long a worker cannot return to work after an injury due to violence, and the median number of days for healthcare workers in this situation is 14.

Explore States’ Approach, Pleas for Federal Action

Some states have brought forth legislation to protect healthcare workers in their workplace. Gretchen Whitmer, governor of Michigan, recently signed legislation increasing the fines for people who harass or assault healthcare workers.

Some states require healthcare workplaces to maintain workplace violence prevention programs, and other states have laws about assault or harassment that specifically mention healthcare workers but can be applied to workers across other industries as well. Other states have legislated protections only for workers in certain segments of the healthcare industry, like people who work in emergency departments.

The COVID-19 pandemic increased number the workplace violence incidents, especially for healthcare workers of certain demographics. This is why the AHA and other industry advocacy groups have been pushing for federal legislation to protect healthcare workers from violence in their workplaces across the country, thereby eliminating the patchwork protections. The AHA notes that the airline industry, which has also faced an increase in violence since the pandemic, has federal laws protecting airline employees and relevant enforcement, and says everyone is safer as a result.

“Despite the incidence of workplace violence and its harmful effects on our health care system, no federal law protects health care employees from workplace assault or intimidation. By contrast, there are federal laws on the books criminalizing assault and intimidation against airline employees, and Attorney General Merrick Garland recently directed Department of Justice prosecutors to prioritize prosecutions under that statute given the rise in violent behavior on commercial aircraft during the COVID-19 pandemic. Vigorous enforcement of these federal laws creates a safe traveling environment, deters violent behavior, and ensures that offenders are appropriately punished,” the AHA says.

Although federal legislation has not passed, as of publication, some federal agencies are tying to accomplish similar goals. For example, the BLS collects information on healthcare workplace violence, which legislators and government agencies can use in constructing policies. In February 2023, OSHA released a draft regulatory framework, “Prevention of Workplace Violence in Healthcare and Social Assistance Issues Document,” which details how the agency aims to standardize and require violence prevention measures and other protections for healthcare workers.

Beware That Bigotry May Impact Violence Crisis

Many healthcare workers, especially those of Asian descent, remain at particular risk of becoming victims of violence amidst the rise of xenophobia during the COVID-19 pandemic.

Additionally, healthcare workers are experiencing workplace-related harassment — personal attacks that intersect with their professional responsibilities related to vaccination, guns, patient care, race, and religion — even when off the clock, according to a letter by Tricia R. Pendergrast; Shikha Jain, MD; N. Seth Trueger, MD, MPH, et. al., detailing survey responses, published in JAMA Internal Medicine in January 2021. You can find out more at https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2774727.

“Simply telling our colleagues in medicine to cope with harassment and menacing behavior is unacceptable. It is imperative that physicians and health professionals feel safe and secure, whether we’re caring for patients or working to advance equity on a broad scale in our communities,” said Gerald E. Harmon, past president of the American Medical Association (AMA), in a piece about the dangers of violence and intimidation against healthcare workers.